Displaying publications 101 - 120 of 814 in total

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  1. Fulltext Mothers’ knowledge of fluoride toothpaste usage by their preschool - children
    Tay HL, Jaafar N
    Malaysian Dental Journal, 2008;29(2):140-148.
    MyJurnal
    Background: Mothers play an important role in preventing fluorosis due to inadvertent swallowing of fluoridated toothpaste and enhancing the effectiveness of toothbrushing amongst preschool children through proper supervision.
    Aim: To investigate the knowledge of mothers with regards to the benefits and risks of fluoride toothpaste usage among preschool children and to assess the level of parental supervision during toothbrushing. In additional, we wish to investigate the toothpaste purchasing behaviour of mothers in relation to brand, price, flavour, fluoride content and the influence of advertisement.
    Methodology: Cross-sectional study of a representative random sample of 373 mothers of 5-6 year old preschool children through self-administered questionnaires.
    Result: The response rate was 90.3% (337). The majority (61.7%) of the mothers reported that the amount of toothpaste their children used was half-length. Most mothers (70.6%) claimed they usually apply toothpaste for their child. About one-half (50.4%) reported the children applied the toothpaste themselves. Only 41.2% of the respondents supervised their children every time during toothbrushing. The mean age at which the child started brushing and using toothpaste was about 34 months (S.D. 14.9) and 37 months (S.D.14.8) respectively. Almost all (95.8%) reported that their children rinsed their mouth after toothbrushing. The mothers’ choice of toothpaste for their child was influence by brand (91.4%), flavour (91.4%) and fluoride content (84.6%) with price being the least of the factors. The majority of the respondents (82.7%) had average to good overall knowledge scores. There was significant association (P=0.034) between the level of education of the mothers and their level of knowledge on fluoride toothpaste usage.
    Conclusion: Future oral health messages for preschool children and mothers in Perlis should target areas found lacking in terms of knowledge and practices with regards to fluoride toothpaste usage. This includes regular supervision of preschool children during toothbrushing by parents and using only a small amount of toothpaste for young children.
    Matched MeSH terms: Risk Assessment
  2. Fulltext Environmental health and building related illnesses
    Ambu, Stephen, Chu, Wan-Loy, Mak, Joon-Wah, Wong, Shew-Fung, Chan, Li-Li, Wong, Siew-Tung
    International e-Journal of Science, Medicine & Education, 2008;2(3):-.
    MyJurnal
    Malaysia has good environmental laws to protect the outdoor environment and public health. However there are no laws governing indoor air quality (IAQ) and the knowledge among the public about its importance is also lacking. Environmental professionals think it is not a priority and this influences the policy decisions in the country. Therefore there is a need to create awareness by way of research, education and other promotional activities. What is much needed at this time is the establishment of standards for the conduct of risk assessment studies. To establish standards we need reliable data which can be used to develop appropriate guidelines for the purpose of mitigation and adaptation programmes. IAQ can have significant influence on health resulting in drop in productivity and economy of a country. It has been estimated that in the US, building related illnesses (BRI) symptoms have a relationship with decrease (3 to 5%) in work performance in an affected population resulting in an annual loss of US$60 billion in revenue. However, based on efficient management programmes they have also projected that the potential annual savings can be in the region of US$10 to 30 billion. This establishes that fact that good management programmes based on efficient guidelines is of economic value to a country and wellbeing of the population. The IMU has embarked on a research programme to collect the much-needed data for the framing of a good IAQ guideline for Malaysia.
    Matched MeSH terms: Risk Assessment
  3. Reducing risk through real options in systems design: the case of architecting a maritime domain protection system
    Buurman J, Zhang S, Babovic V
    Risk Anal, 2009 Mar;29(3):366-79.
    PMID: 19076327 DOI: 10.1111/j.1539-6924.2008.01160.x
    Complex engineering systems are usually designed to last for many years. Such systems will face many uncertainties in the future. Hence the design and deployment of these systems should not be based on a single scenario, but should incorporate flexibility. Flexibility can be incorporated in system architectures in the form of options that can be exercised in the future when new information is available. Incorporating flexibility comes, however, at a cost. To evaluate if this cost is worth the investment a real options analysis can be carried out. This approach is demonstrated through analysis of a case study of a previously developed static system-of-systems for maritime domain protection in the Straits of Malacca. This article presents a framework for dynamic strategic planning of engineering systems using real options analysis and demonstrates that flexibility adds considerable value over a static design. In addition to this it is shown that Monte Carlo analysis and genetic algorithms can be successfully combined to find solutions in a case with a very large number of possible futures and system designs.
    Matched MeSH terms: Risk Assessment
  4. Prevalence and risk factors for peripheral artery disease in an Asian population with diabetes mellitus
    Tavintharan S, Ning Cheung, Su Chi Lim, Tay W, Shankar A, Shyong Tai E, et al.
    Diab Vasc Dis Res, 2009 Apr;6(2):80-6.
    PMID: 20368197 DOI: 10.1177/1479164109336043
    We describe the prevalence and risk factors for PAD in Asian Malays with diabetes. A population-based study of 3,280 (78.7% response) Malay persons aged 40-80 years in Singapore was conducted. ABI was measured in all participants with a history of diabetes (N=634). PAD was defined to be present if ABI risk factor assessment. The crude prevalence of PAD was 10.4% (95% CI: 8.3%-13.0%). After age standardisation to the 2000 Singapore Census population, the prevalence was 5% (95% CI: 3.8-8.6). In multivariate analyses, the presence of PAD was associated with older age (OR 1.05; 95% CI: 1.01-1.09, per year increase), female gender (OR 4.18; 95% CI: 1.67-10.43), cigarette smoking (OR 2.55; 95% CI: 1.05-6.20), higher systolic blood pressure (OR 1.28; 95% CI: 1.13-1.45), a history of myocardial infarction (OR 3.69; 95% CI: 1.79-7.61) and stroke (OR 3.06 95% CI: 1.25-7.50). In this Asian Malay population with diabetes, we found a high prevalence of PAD.The major risk factors for PAD among persons with diabetes are similar to studies in Caucasian populations, suggesting that strategies aimed at controlling the modifiable factors may reduce the prevalence of PAD in Asian populations.
    Matched MeSH terms: Risk Assessment
  5. Radiological monitoring: terrestrial natural radionuclides in Kinta District, Perak, Malaysia
    Lee SK, Wagiran H, Ramli AT, Apriantoro NH, Wood AK
    J Environ Radioact, 2009 May;100(5):368-74.
    PMID: 19299052 DOI: 10.1016/j.jenvrad.2009.01.001
    Natural background gamma radiation and radioactivity concentrations were investigated from 2003 to 2005 in Kinta District, Perak, Malaysia. Sample locations were distant from any 'amang' processing plants. The external gamma dose rates ranged from 39 to 1039 nGy h(-1). The mean external gamma dose rate was 222+/-191 nG yh(-1). Small areas of relatively enhanced activity were located having external gamma dose rates of up to 1039+/-104 nGy h(-1). The activity concentrations of (238)U, (232)Th and (40)K were analyzed by using a high-resolution co-axial HPGe detector system. The activity concentration ranges were 12-426 Bq kg(-1) for (238)U, 19-1377 Bq kg(-1) for (232)Th and <19-2204 Bq kg(-1) for (40)K. Based on the radioactivity levels determined, the gamma-absorbed dose rates in air at 1m above the ground were calculated. The calculated dose rates and measured dose rates had a good correlation coefficient, R of 0.94. To evaluate the radiological hazard of the natural radioactivity, the radium equivalent activity, the gamma-absorbed dose rate and the mean population weighted dose rate were calculated. An isodose map for the Kinta District was also produced.
    Matched MeSH terms: Risk Assessment
  6. Is 6% hydroxyethyl starch 130/0.4 safe in coronary artery bypass graft surgery?
    Ooi JS, Ramzisham AR, Zamrin MD
    Asian Cardiovasc Thorac Ann, 2009 Aug;17(4):368-72.
    PMID: 19713332 DOI: 10.1177/0218492309338101
    The aim of this study was to compare 6% hydroxyethyl starch 130/0.4 with 4% succinylated gelatin for priming the cardiopulmonary bypass circuit and as volume replacement in patients undergoing coronary artery bypass, in terms of postoperative bleeding, blood transfusion requirements, renal function, and outcome after surgery. Forty-five patients received 6% hydroxyethyl starch 130/0.4 (Voluven) and another 45 were given 4% succinylated gelatin (Gelofusine) as the priming solution for the cardiopulmonary bypass circuit as well as for volume replacement. Postoperative bleeding was quantified from the hourly chest drainage in the first 4 h and at 24 h postoperatively. The baseline characteristics of both groups were similar. In the hydroxyethyl starch group, the total amount of colloid used was 1.9 +/- 1.0 L, while the gelatin group had 2.0 +/- 0.7 L. There was no significant difference in hourly chest drainage between groups. Blood transfusion requirements, estimated glomerular filtration rate, extubation time, intensive care unit and hospital stay were similar in both groups. It was concluded that 6% hydroxyethyl starch 130/0.4 is a safe alternative colloid for priming the cardiopulmonary bypass circuit and volume replacement in patients undergoing coronary artery bypass surgery.
    Matched MeSH terms: Risk Assessment
  7. Hazarding health: experiences of body, work, and risk among factory women in Malaysia
    Root R
    Health Care Women Int, 2009 Oct;30(10):903-18.
    PMID: 19742364 DOI: 10.1080/07399330903042807
    In the 1970s, Malaysia launched an export-oriented development strategy as a means of financing the nation's modernization. The success of the strategy hinged significantly on intensive recruitment of women for factory employment. I draw on descriptive qualitative research, including interviews (51), surveys (106), and ethnography in Malaysia to investigate factory women's experiences of work and work-related health risks. Discourse analysis surfaced a latent consciousness of bodily changes in relation to work. A grounded theory analysis showed a compromised access to occupational risk knowledge that may bear negatively on women's well-being and the role women's new labor identities played in mediating the meanings of work and risks. Given the predominance of women workers in low-end manufacturing globally, I aimed to contribute to theoretical and applied understandings of gender, globalization, and health.
    Matched MeSH terms: Risk Assessment
  8. Fulltext Outbreak management during the worst flood disaster of 2006–2007 in Johore, Malaysia
    Arbaiah, O., Badrul, H.A.S., Marzukhi, M.I., Mohd Yusof, Badaruddin, M., Mohd Adam
    Malaysian Journal of Community Health, 2009;15(3):111-118.
    MyJurnal
    Outbreak management in disaster has to be planned and implemented prior to, during and after the disaster is over. The risk of outbreaks following disaster is related to the size, health status and living conditions of the displaced population. The risk is increased due standing water in floods for vector borne diseases, overcrowding, inadequate water and sanitation and poor access to health care. The 2006-2007 flood in Johore resulted in 2 episodes of food poisoning and an outbreak of coxsackie A24 acute haemorrhagic conjunctivitis. Only 19,667 (12.5%) of the 157,018 displaced persons suffered from communicable diseases which comprised of acute respiratory disease 7361(28%), skin infection 4241(19%), acute gastroenteritis 1872(8%) and conjunctivitis 589 (2%). The routine disease surveillance and environmental control were enhanced to cover the relief centers and flood areas. Risk assessment of communicable disease carried out resulted in prompt control measures and good coverage of preventive activities. In conclusion the Johore State Health Department has successfully manage the outbreaks during the major flood.
    Matched MeSH terms: Risk Assessment
  9. Spatial assessment of Langat River water quality using chemometrics
    Juahir H, Zain SM, Aris AZ, Yusoff MK, Mokhtar MB
    J Environ Monit, 2010 Jan;12(1):287-95.
    PMID: 20082024 DOI: 10.1039/b907306j
    The present study deals with the assessment of Langat River water quality with some chemometrics approaches such as cluster and discriminant analysis coupled with an artificial neural network (ANN). The data used in this study were collected from seven monitoring stations under the river water quality monitoring program by the Department of Environment (DOE) from 1995 to 2002. Twenty three physico-chemical parameters were involved in this analysis. Cluster analysis successfully clustered the Langat River into three major clusters, namely high, moderate and less pollution regions. Discriminant analysis identified seven of the most significant parameters which contribute to the high variation of Langat River water quality, namely dissolved oxygen, biological oxygen demand, pH, ammoniacal nitrogen, chlorine, E. coli, and coliform. Discriminant analysis also plays an important role as an input selection parameter for an ANN of spatial prediction (pollution regions). The ANN showed better prediction performance in discriminating the regional area with an excellent percentage of correct classification compared to discriminant analysis. Multivariate analysis, coupled with ANN, is proposed, which could help in decision making and problem solving in the local environment.
    Matched MeSH terms: Risk Assessment
  10. Clinical characteristics of basal cell carcinoma in a tertiary hospital in Sarawak, Malaysia
    Yap FBB
    Int J Dermatol, 2010 Feb;49(2):176-9.
    PMID: 20465642 DOI: 10.1111/j.1365-4632.2009.04342.x
    BACKGROUND: Basal cell carcinoma (BCC) is the most common skin cancer among Orientals. Data on this malignancy is lacking in Malaysia, prompting a retrospective study to determine the clinical characteristics in the skin clinic, Sarawak General Hospital between 2000 and 2008.
    METHODS: Demographic data and clinical features of 64 histopathologically proven BCC from 43 patients were retrieved. Statistical analysis was performed comparing the clinical characteristics based on the region of involvement and gender.
    RESULTS: The mean age of presentation was 60.9 years. Male to female ratio was 1.05. Majority of the patients were Chinese (44.2%) followed by Malays (32.6%), Bidayuhs (14.0%) and Ibans (6.9%). Nodular BCC accounted for 95.3% of cases while 4.7% were superficial BCC. All the nodular BCC were pigmented. Ulceration was noted in 18%. There were 82.8% of BCC on the head and neck region and 17.2% on the trunk and limb region. BCC on the latter region were larger (mean 35.0 cf. 14.4 mm, p < 0.001) and ulcerated (45.5% cf. 11.3%, p = 0.01). Superficial BCC were also more frequently encountered in this region (18.2% cf. 1.9%, p = 0.02). Compared to women, men had larger BCC (mean 21.1 cf. 13.3 mm, p = 0.03) and kept them for a longer duration (mean 21.6 cf. 13.3 months, p = 0.04).
    CONCLUSION: Clinical characteristics of BCC in Sarawak were similar to other Asian studies. Additionally, BCC on the trunk and limbs and in men were larger, ulcerative and long standing warranting better efforts for earlier detection.
    Study site: Skin clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia
    Matched MeSH terms: Risk Assessment
  11. The end of the line: who is most at risk from the crisis in global fisheries?
    Hall SJ, Dugan P, Allison EH, Andrew NL
    Ambio, 2010 Feb;39(1):78-80.
    PMID: 20496655
    Matched MeSH terms: Risk Assessment
  12. Fulltext A medication-estimated health status measure for predicting primary care visits: the Long-Term Therapeutic Groups Index
    Dhabali AA, Awang R
    Health Policy Plan, 2010 Mar;25(2):162-9.
    PMID: 19923207 DOI: 10.1093/heapol/czp051
    BACKGROUND: Managed care is one of the means advocated for health care reforms. The Malaysian government has proposed managed care for its citizens. In the Malaysian private health care sector, managed care is practised on a small scale with crude risk adjustment. The main determinant of an individual's health service utilization is their health status (HS). HS is used as a risk adjuster for capitation payment. Prescribed medications represent a useful source for HS estimation. We aimed to develop and validate a medication-based HS estimate and to incorporate it in the Andersen model of health service utilization. This is a preparatory step in studying the feasibility of developing a model for risk assessment in the Malaysian context.
    METHODS: Data were collected retrospectively from an academic year from computerized databases in University Sains Malaysia (USM) about users of USM primary care services. A user is a USM health scheme beneficiary who made at least one visit in the academic year to USM-assigned primary care providers. Socio-demographic variables, enrolment period, medications prescribed and number of visits were also collected. Chronic illness medications and some non-chronic illness medications were used to calculate the Long-Term Therapeutic Groups Index (LTTGI) which is an estimate of the HS of users. Using a random 50% of users, weighted least square methods were used to develop a model that predicts a user's number of visits. The other 50% were used for validation.
    RESULTS: Socio-demographic variables explained 15% of variability in number of primary care visits among users. Adding the LTTGI improved the explanatory power of the model to 36% (P < 0.001). A similar contribution of the LTTGI was noted in the validation.
    CONCLUSIONS: The Long-Term Therapeutic Groups Index was successfully developed. Variability in number of primary care visits can be predicted by LTTGI-based models.
    Matched MeSH terms: Risk Assessment
  13. Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more
    Mansor A, Arumugam K, Omar SZ
    Eur J Obstet Gynecol Reprod Biol, 2010 Mar;149(1):44-6.
    PMID: 20042263 DOI: 10.1016/j.ejogrb.2009.12.003
    To determine if shoulder dystocia can be predicted in babies born weighing 3.5 kg or more.
    Matched MeSH terms: Risk Assessment
  14. Complications after tenckhoff catheter insertion: a single-centre experience using multiple operators over four years
    Liu WJ, Hooi LS
    Perit Dial Int, 2010 03 12;30(5):509-12.
    PMID: 20228175 DOI: 10.3747/pdi.2009.00083
    OBJECTIVE: To analyze the complications after Tenckhoff catheter insertion among patients with renal failure needing dialysis. ♢

    PATIENTS AND METHODS: The open, paramedian approach is the commonest technique to insert the 62-cm coiled double-cuffed Tenckhoff peritoneal catheter. All patients with catheters inserted between January 2004 and November 2007 were retrospectively analyzed for demographics and followed for up to 1 month for complications. We excluded patients whose catheters had been anchored to the bladder wall and who underwent concurrent omentectomy or readjustment without removal of a malfunctioning catheter (n = 7). Intravenous cloxacillin was the standard preoperative antibiotic prophylaxis. ♢

    RESULTS: Over the 4-year study period, 384 catheters were inserted under local anesthetic into 319 patients [201 women (62.8%); mean age: 49.4 ± 16.7 years (range: 13 - 89 years); 167 (52.2%) with diabetes; 303 (95%) with end-stage renal disease] by 22 different operators. All Tenckhoff catheters were inserted by the general surgical (n = 223) or urology (n = 161) team. There were 29 cases (7.6%) of catheter migration, 22 (5.7%) of catheter obstruction without migration, 24 (6.3%) of exit-site infection, 12 (3.1%) of leak from the main incision, 14 (3.6%) of culture-proven wound infection, 11 (2.9%) post-insertion peritonitis, and 1 (0.3%) hemoperitoneum. No deaths were attributed to surgical mishap. ♢

    CONCLUSIONS: The most common complication was catheter migration. The paramedian insertion technique was safe, with low complication rates.

    Matched MeSH terms: Risk Assessment
  15. Unhealthy travelers present challenges to sustainable primate ecotourism
    Muehlenbein MP, Martinez LA, Lemke AA, Ambu L, Nathan S, Alsisto S, et al.
    Travel Med Infect Dis, 2010 May;8(3):169-75.
    PMID: 20541137 DOI: 10.1016/j.tmaid.2010.03.004
    Ecotourism can function as a powerful tool for species conservation. However, a significant proportion of travelers at wildlife sanctuaries may be ill and potentially infectious, creating unnecessary risk of pathogen transmission to wildlife.
    Matched MeSH terms: Risk Assessment
  16. Fulltext ABCB1 C3435T polymorphism and the risk of resistance to antiepileptic drugs in epilepsy: a systematic review and meta-analysis
    Haerian BS, Roslan H, Raymond AA, Tan CT, Lim KS, Zulkifli SZ, et al.
    Seizure, 2010 Jul;19(6):339-46.
    PMID: 20605481 DOI: 10.1016/j.seizure.2010.05.004
    The C3435T, a major allelic variant of the ABCB1 gene, is proposed to play a crucial role in drug-resistance in epilepsy. The C/C genotype carriers reportedly are at higher risk of pharmacoresistance to AEDs, but only in some studies. The hypothesis of the C-variant associated risk and resistance to antiepileptic drugs (AEDs) has been hampered by conflicting results from inadequate power in case-control studies. To assess the role of C3435T polymorphism in drug-resistance in epilepsy, a systematic review and meta-analysis was conducted.
    Matched MeSH terms: Risk Assessment
  17. Fulltext Complete congenital third branchial fistula: does the theoretical course apply?
    Aneeza WH, Mazita A, Marina MB, Razif MY
    Singapore Med J, 2010 Jul;51(7):e122-5.
    PMID: 20730387
    The course of a third branchial fistula is derived from its embryological origin, in accordance with the branchial apparatus theory. Treatment of this condition requires complete removal of the tract in order to avoid recurrence; however, this can pose a risk to the surrounding structures. We report the case of a complete third branchial fistula as well as a literature review on its theoretical course and management.
    Matched MeSH terms: Risk Assessment
  18. Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study
    Ma NH, Teh CL, Rapaee A, Lau KB, Fong AY, Hi S, et al.
    Int J Rheum Dis, 2010 Aug;13(3):223-9.
    PMID: 20704618 DOI: 10.1111/j.1756-185X.2010.01533.x
    INTRODUCTION: Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population.
    OBJECTIVE: The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi-detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-senstivity C-reactive protein (hs-CRP) to detect subclinical atherosclerosis in RA patients.
    METHODS: We performed a comparative cross-sectional study of 47 RA patients who were in remission with a control group of non-RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64-slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT-proBNP and hsCRP.
    RESULTS: There were 94 patients in our study with a mean age of 50 +/- 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (P = 0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients.
    CONCLUSIONS: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.
    Study site: Sarawak General Hospital, Kuching, Sarawak, Malaysia
    Matched MeSH terms: Risk Assessment
  19. Security threats categories in healthcare information systems
    Samy GN, Ahmad R, Ismail Z
    Health Informatics J, 2010 Sep;16(3):201-9.
    PMID: 20889850 DOI: 10.1177/1460458210377468
    This article attempts to investigate the various types of threats that exist in healthcare information systems (HIS). A study has been carried out in one of the government-supported hospitals in Malaysia.The hospital has been equipped with a Total Hospital Information System (THIS). The data collected were from three different departments, namely the Information Technology Department (ITD), the Medical Record Department (MRD), and the X-Ray Department, using in-depth structured interviews. The study identified 22 types of threats according to major threat categories based on ISO/IEC 27002 (ISO 27799:2008). The results show that the most critical threat for the THIS is power failure followed by acts of human error or failure and other technological factors. This research holds significant value in terms of providing a complete taxonomy of threat categories in HIS and also an important component in the risk analysis stage.
    Matched MeSH terms: Risk Assessment
  20. Fulltext Pulmonary embolectomy in heparin-induced thrombocytopenia and thrombosis? Safety of heparin use
    Sachithanandan A
    Interact Cardiovasc Thorac Surg, 2010 Nov;11(5):681.
    PMID: 20962169 DOI: 10.1510/icvts.2010.247460A
    Matched MeSH terms: Risk Assessment
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